• Clinical Nutrition Research
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• v.12 no.3
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• pp.218-228
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• 2023

Recent studies have evaluated the association between specific beverage intake and metabolic risks in adults. However, more evidence is needed to examine the association between the Healthy Beverage Index (HBI) and metabolic factors. Therefore, this study investigated the relationship between HBI and metabolic factors in adults. In this cross-sectional study, 338 overweight and obese individuals living in Tabriz, Iran were selected. Data on beverage consumption, demographics, physical activity, and anthropometric characteristics were evaluated using validated standard protocols. The predefined HBI was calculated based on previous studies. The mean value of HBI index among all of the participants was 59.76 ± 6.51. Those at the higher HBI scores had significantly lower waist circumference, waist-to-hip ratio, fat mass, and weight (p < 0.05). HBI and triglyceride scores also had a significant relationship. It has been shown that at higher HBI scores compared to lower scores, high-density lipoprotein cholesterol levels increase while homeostatic model assessment for insulin resistance, low-density lipoprotein cholesterol, total cholesterol, and blood pressure decrease. HBI scores higher among Iranian adults were associated with a better chance of losing weight and weight loss and a better lipid profile, and lower blood pressure. Therefore, HBI can be a useful and helpful tool for assessing the overall quality of beverages adults consume. However, further studies are warranted to confirm the possible health effects of healthy beverage index.

• Journal of the Korean Dietetic Association
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• v.29 no.3
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• pp.173-189
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• 2023

This study aimed to determine foodservice and hygiene management statuses at welfare facilities catering to disabled persons by facility type to provide basic data for foodservice management guidelines. An online survey was distributed to workers at 1,984 welfare facilities for disabled persons in Korea, and 531 facilities responded, which represented a response rate of 26.8%. The survey requested general information about the facilities, facility users, meals, hygiene, and management. Statistical analyses were performed, and frequency analysis and the chi-square test were used to investigate responses by facility type. The survey results revealed that daycare centers were most common and accounted for 27.4% of responses. Residential facilities for the severely disabled and sheltered workshops accounted for 16.9% and 16.4%, respectively, and residential facilities by disability type accounted for 13.0%. The presence of dietitians at welfare facilities varied by facility type. Welfare centers for the disabled (94.7%) had the highest percentage of dietitians, followed by residential facilities for the severely disabled (87.8%). On the other hand, sheltered workshops and daycare centers for disabled persons had the lowest percentages of dietitians (10.3% and 4.1%, respectively). This study highlights the variations that exist in foodservice management across different welfare facilities for disabled persons and emphasizes the challenges faced by those responsible for managing foodservices and maintaining hygiene, particularly in large facilities with no dietitians. Therefore, we recommend tailored meal management guidelines be developed for each type of welfare facility for disabled persons.

• Nutrition Research and Practice
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• v.15 no.5
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• pp.655-671
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• 2021

BACKGROUND/OBJECTIVES: While plate waste has been widely investigated in hospitals, there have been minimal studies specific to the texture-modified diet (TMD). This study aims to determine the percentage of plate waste among patients prescribed with TMD and its contributory factors. SUBJECTS/METHODS: This was a single-centre study conducted in the university hospital on three types of TMD (blended diet, mixed porridge, minced diet) during lunch and dinner meals. Weighing method and visual estimation method assisted by digital photograph were adopted in this study. Face to face interview was carried out to investigate on 1) the food/food service quality factors in terms of patients' satisfaction level towards sensorial quality of food and food services provided and 2) the clinical/external factors including appetite, the provision of oral nutrition support, time taking the diet, the need for feeding assistance and the length of hospital stay. RESULTS: The mean percentage of overall plate waste of 95 patients receiving TMD was high (47.5%). Blended diet was identified as the most wasted diet (65%) followed by minced diet (56%) and mixed porridge (35%). Satisfaction level among patients was moderate. Patients on TMD in general had higher satisfaction level on the aspect of food service as compared to food quality. Substantial association between sensorial qualities of food and plate waste were varied according to individual TMD type. A multiple linear regression showed that only the satisfaction level toward the aspects of appearance and variety of foods were the predictors of TMD plate waste (R² = 0.254, P < 0.05). CONCLUSIONS: A significant relationship between the percentage of plate waste and the overall satisfaction level of patients receiving TMD suggests that vigorous strategies are needed to reduce the food waste of TMD which will lead to a better nutritional status and clinical outcomes among the patients.

• Journal of the Korean Dietetic Association
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• v.20 no.4
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• pp.257-274
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• 2014

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.295-305
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• 2023

Purpose: This study compared health behaviors and health-related clinical characteristics between individuals with normal glucose levels without diabetes and those with undiagnosed diabetes. Factors that were associated with undiagnosed diabetes were identified by sex. Methods: This was an observational study with a cross-sectional design based on data from the eighth Korea National Health and Nutrition Examination Survey, which used a stratified, multi-stage, cluster-sampling design to obtain a nationally representative sample. Multiple logistic regression analysis was employed to compute the odds ratios of health behaviors and clinical characteristics to identify risk factors for undiagnosed diabetes. Results: The overall prevalence of undiagnosed diabetes was 5.2% (weighted %, n = 700, p < .001). Among individuals with undiagnosed diabetes, 58.3% were men. Univariate logistic regression for undiagnosed diabetes identified sex, age, house income, educational level, and triglycerides as influencing factors. In multiple logistic regression by sex, the factors associated with undiagnosed diabetes in men were age, perceived health status, a diagnosis of angina, and triglycerides. Conclusion: Strategies should be targeted to improve health behaviors and clinical characteristics for specific age groups, men in bad perceived health status, women with high systolic blood pressure, and high triglycerides. Moreover, healthcare providers should understand the barriers to health behaviors and health-related quality of life to effectively deliver healthcare services.

• Korean Journal of Community Nutrition
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• v.15 no.5
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• pp.694-703
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• 2010

Recent studies have reported that a subset of obese individuals who were metabolically healthy but obese had more favorable clinical outcomes than obese subjects with metabolic disturbances. The purpose of this study was to evaluate the distribution and agreement of obesity subtypes according to body mass index (BMI) and metabolic syndrome (MS). Furthermore, we examined the differences of nutrient intake among the groups. Data was analyzed for 1,095 female subjects older than 40 years using Korean National Health and Nutrition Survey in 2008. The degree of obesity was classified by two methods, using BMI (obese ${\geq}\;25\;kg/m^2$, not obese < $25\;kg/m^2$) and MS (meet ${\geq}\;3$ criteria among 5 index: waist circumference, triglyceride, glucose, HDL-cholesterol and blood pressure). Subjects were divided into 4 groups according to $2{\times}2$ cross table: non-obese without MS, non-obese with MS, obese without MS and obese with MS. Nutrient intakes were compared among 4 groups. The results showed that the proportions of non-obese without MS, non-obese with MS, obese without MS and obese with MS were 47.6%, 13.6%, 16.6%, and 22.2% of total subjects, respectively. The agreement (kappa value) of two methods was 0.354 (fair) in total subjects, 0.365 (fair) in 40-60 year old subjects and 0.304 (fair) in ${\geq}\;61$ year old subjects. In ${\geq}\;61$ years old subjects, intakes of percentage energy from carbohydrate, percentage of energy from fat, calcium, phosphorous, sodium, vitamin A, carotene, thiamine, riboflavin and niacin were significantly different among the groups. In contrast, the subjects of 40-60 years old, no differences in nutrient intakes were observed. In conclusion, there were differences in nutrient intakes among the groups subdivided by obesity and MS, especially in elderly female subjects. Individualized dietary guideline for subtype of obesity will be needed to treat metabolic disturbance of obesity.

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.147-155
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• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

• Nutrition Research and Practice
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• v.15 no.sup1
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• pp.32-40
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• 2021

BACKGROUND/OBJECTIVES: Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19. SUBJECTS/METHODS: This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality. RESULTS: The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality. CONCLUSIONS: Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.1
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• pp.59-86
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• 2023

Purpose: Information regarding functional gastrointestinal disorders (FGIDs) in infants is currently lacking in Indonesia. This study aimed to describe the prevalence and risk factors of FGIDs in infants aged 6 weeks to 4 months in Indonesia. Methods: This cross-sectional study of 433 infants was conducted between September 2018 and February 2020. Information on FGIDs was collected using the Infant Gastrointestinal Symptom Questionnaire and the Feeding Practice and Gut Comfort Questionnaire. Adapted Rome IV criteria were used to define the FGIDs. Results: The prevalence of regurgitation was 26.3%; 16.8% of the infants presented cryingrelated symptoms and 5.5% exhibited constipation. The statistical analyses revealed that constipation was associated with sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.07-7.71; p=0.043), employment of the father (OR, 0.3; 95% CI, 0.12-0.77; p=0.01), and education of the mother (OR, 1.92; 95% CI, 1.07-3.51; p=0.031). Length at birth (OR, 0.74; 95% CI, 0.55-0.99; p=0.042) was associated with constipation. Length at visit (OR, 0.83; 95% CI, 0.76-0.91; p<0.001) was associated with regurgitation, and the weight at visit (OR, 0.58; 95% CI, 0.35-0.96; p=0.038) was associated with crying and/or colic. A history of parental FGIDs was associated with crying-related symptoms (OR, 2.12; 95% CI, 1.23-3.68; p=0.007). Conclusion: Regurgitation, crying, and constipation are common FGIDs in infants. Some parental and infant characteristics may be predictors for FGIDs. Further investigations are needed to evaluate the clinical relevance of our findings. Understanding the determinants of FGIDs will benefit healthcare professionals and parents to improve infant's quality of life and better manage these condition.

• Journal of Nutrition and Health
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• v.13 no.1
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• pp.15-26
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• 1980

The main purposes of the nutrition and clinical surveys were to provide baseline information on the nutritional status of pre-school children in rural health demonstration project areas of the Korea Health Development Institute (KHDI) for nutrition guidance services for the MCH target group. The survey covered a total of 222 pre-school children and 135 mothers in Okgu Gun, Cholla Pukto Province from August 10 to August 17, 1979. The survey results are summarized as follows: 1) Family Environment Seventy percent of the households had more than three children, and the mean family sire was 6. Sixty-nine percent of the mothers and 47% of the fathers of the surveyed households were educated at or below the primary school level. The majority, 70% of the mothers, were aged between 20 years and 35 years. 2) Anthropometric Measurements and Hemoglobin Value 4.5% of the children were lower than 80% weight for age of the Korean standard, and 5.4% were lower than 85% arm circumference for age of the Jelliffe's standard resectively, and those were suffering from protein-energy malnutrition. Angular stomatitis were observed on 66.2% of the subjects. Mean hemoglobin value was 11.1g/100m1, and 44.2% of the subjects were categorized as anaemia. 3) Food and Nutrient Intake of animal foods was very low, ranging from 2.9 to 17%. Consumption of eggs was less than 2% of total food intake, and intake of legumes was also very scanty, between 0.8 to 3.7%. These data present evidence of very poor protein intake, quality as well as quantity. Energy intake of children was 60.0 to 64.4% of the recommended allowance, and mean protein intake only met 47.4% of the recommendation. Low intake of vitamins except thiamin were also found. 4) Mother's Nutrition Knowledge Eighty-five percent of the mothers were entirely ignorant regarding the 'five basic food group' which is most important fact on food and nutrition guidance. Mean knowledge score from 14 basic questions about food and nutrition was as low as 5.1. There was a significant positive correlation between mother's educational level and nutrition knowledge score. 5) Family Planning Variable There were significant correlation among maternal, family planning variables, and some of the nutritional and physical measurements. The study revealed that the mother's educational level and nutrition knowledge score are more crucial factors than the family planning variables on effecting food intakes on children. Recommendation : According to the results of the surveys, there were high incident rates of nutritional anaemia and angular stomatitis among pre-school children, and most of rural women had very limited knowledge about food and nutrition. As a main part of the health education activities, the community health workers should provide nutrition education to the village mothers to improve the nutrional status of young children in rural areas. Nutrional promotion at the primary health care level should be mainly based on appropriate nutrition education.